Sunday, January 03, 2010
Two Cheers for the Health Care Bill
Nowadays there are several kinds of Democrat. There are blue dog Democrats, yellow dog Democrats, conservative Democrats, progressive Democrats, liberal Democrats, etc., etc., etc. As Willl Rogers once noted, we are not an organized party. I have been a member of a Democratic club ever since my wife and I moved to California in 1955. It hasn't been the same club all the time. The first one I joined died after the reelection of Nixon in 1972. The one that I joined more than ten years ago has recently stopped functioning because no one wanted to be an officer. I will, of course, join another club soon.
I know of at least two Democratic clubs in my area that pride themselves on being "Progressive." It's taken me a while to figure out what that means. I'm not sure I know yet, but they seem to subscribe to a national group called "Progressive Democrats of America," or PDA for short. One of my friends is enthusiastic about being a member of a "Progressive" Democratic club. I haven't made a practice of visiting other clubs often, but as far as I can tell there isn't any difference in the attitude of the members toward important issues and candidates between clubs that say they are "Progressive" and clubs that don't.
All of this introduction is preparation for my own ideological identification. I consider myself a Social Democrat. That is, I favor certain aspects of socialism, such as Social Security and Medicare. I also favor a health care reform based on the single-payer system, in which medical services are paid for by either the government itself or by a non-profit insurance plan subsidized in part by government. I also recognize that the current health care system in this country has two important failings: First, not everyone has access to needed medical services and thousands of people die each year because of this. Second, our health care system is the most expensive in the world, even for people who have access to the best care available.
The current legislation in Congress, with different versions in the Senate and House, does not do anything effective to guarantee health care access to everyone. All it does is require that everyone purchase health insurance and provide subsidies for people whose incomes are low and who can't afford the premiums. It does attack the problem of the high cost. I've read several articles published in the New Yorker magazine by Dr. Atul Gawande. He writes about the high cost of American medical practice. In his latest article he points out that the government can not by law mandate a scheme for the practice and delivery of medical care that is sure to reduce the cost while maintaining high quality. He praises the two versions of the bill for providing for experimentation. That is, many pilot programs are proposed to find out what method of providing and paying for health care will produce the desired result: less cost with best quality. Although the two bills amount to big give-aways to the health insurance industry and almost certainly won't provide anywhere near the goal of universal health care, they do promise to do something about the cost. As a Social Democrat, I am used to not getting my way. I am happy to accept the pending legislation as half a loaf, and half a loaf is better than no bread, according to a noted 18th century monarch. If this puts me at odds with the PDA people, so be it.